Manage My health Self-Registration

ManageMyHealth Registration

Kia Orana. TMO is excited to connect with you! Sign up to ManageMyHealth and stay in the know about your health! To help us capture the right data, please make sure that all required fields marked (*) are accurately completed. This will ensure a smooth registration process and help us serve you better. Meitaki Maata.
Check your medical bills status
Have you settled your outstanding bill with TMO?*

YesNo
Please upload a copy of receipt (Optional)

E Receipt or pictures of your physical receipt
Cancelof
For payment assistance or bill inquiries, please contact our reception team at 22664, 20065, or 20066.

Personal information
Full Name (as on passport)*

HonorificsFirst Name/sLast Name
Mobile Number*
Please enter a valid phone number.
Home Phone Number
Please enter a valid phone number.
Personal Email (please do not use work email)*
example@example.com
Address
What part of the Cook Islands do you currently reside in?

Northern GroupSouthern Group
What Island do you currently reside in?
Please note that Palmerston is in the Northern Group.
Village
What Island do you currently reside in?
Emergency Contact
Full Name*

First Name/sLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Relationship
What is your relationship with your emergency contact
Document upload
Please upload any two of the following valid identification documents. (Please select 2 of the 3 documents below)*

PassportBirth CertificateDrivers license
File Upload

Upload chosen identification documents here
Cancelof
Privacy Statement

The purpose of this privacy statement is to let you know when we collect personal information and what we do with it. We do not use, share or disclose personal information collected or received through this Registration and Manage My Health except as set out in this statement.
Consent for Data Collection and Fee Acknowledgment

By completing this registration form, I agree to the above privacy statement above and understand that TMO will charge an annual fee of NZD1.00, effective 1st July 2025.
NOTE:

Enquiries to previous or missing health records, please contact TMO reception at 20065, 20066 or 22664.

Please verify that you are human*
Should be Empty:

ManageMyHealth Registration

Check your medical bills status

Personal information

Address

Emergency Contact

Document upload